Pericardial decompression syndrome: A rare and potentially dramatic complication of pericardiocentesis

Basmaji, Samir G.; Peretz-Larochelle, Maude; Bernier, Martin

doi:10.1016/j.ijcard.2014.11.077

Cited by 5 publications

(6 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Basmaji et al performed nuclear perfusion imaging in their PDS case and detected fixed perfusion defects without any inducible ischemia. Coronary angiography revealed no significant stenosis, and EF was 57% in magnetic resonance imaging (7) . In our case, it was not possible to investigate ischemia and myocardial disease due to failed resuscitation.…”

Section: Discussionmentioning

confidence: 91%

Pericardial Decompression Syndrome: an Uncommon But Dangerous Complication After Successful Pericardiocentesis

Güler¹,

Güler²,

Demir³

et al. 2017

Kosuyolu Heart Journal

View full text Add to dashboard Cite

Pericardial decompression syndrome (PDS) is an infrequent but mostly fatal complication after successful pericardiocentesis. We present a case of a 27-year-old female patient with suspected malignancy and cardiac tamponade treated with pericardiocentesis, followed by acute pulmonary edema and cardiac arrest 2 hours later. We also reviewed possible mechanisms involved in PDS pathophysiology in the context of literature data.

show abstract

Section: Discussionmentioning

confidence: 91%

Pericardial Decompression Syndrome: an Uncommon But Dangerous Complication After Successful Pericardiocentesis

Güler¹,

Güler²,

Demir³

et al. 2017

Kosuyolu Heart Journal

View full text Add to dashboard Cite

show abstract

“…Two (2.8%) cases reported new-onset right to left shunt occurring after right ventricular failure. 5 7 8 9 10 11 12 14 15 16 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74…”

Section: Resultsmentioning

confidence: 99%

Pericardial Decompression Syndrome: A Comprehensive Review of a Controversial Entity

Sarode,

Patel,

Arrington

et al. 2024

Int J Angiol

View full text Add to dashboard Cite

Pericardial decompression syndrome is an ambiguous clinical entity which has generated controversy regarding its existence. Following pericardial decompression, patients experienced clinical deterioration ranging in complications from pulmonary edema to death that could not be attributed to any other distinct clinical pathology. Multiple theories have suggested the pathophysiology behind pericardial decompression syndrome is related to preload-afterload mismatch following pericardial decompression, coronary microvascular ischemia, and stress from high adrenergic state. Our review aims to describe this syndrome by analyzing demographics, etiology of pericardial effusion, method of drainage, volume of pericardial fluid removed, time to decompensation, and clinical outcomes. A systematic review of MEDLINE/PubMed and Google Scholar literature databases were queried for case reports, case series, review articles, and abstracts published in English journals between 1983 and December 2022. Each author's interpretation of echocardiographic and/or pulmonary arterial catheterization data provided in the case reports was used to characterize ventricular dysfunction. Based on our inclusion criteria, 72 cases of pericardial decompression syndrome were included in our review. Our results showed that phenotypic heterogeneity was present based on echocardiographic findings of right/left or biventricular failure with similar proportions in each type of ventricular dysfunction. Time to decompensation was similar between immediate, subacute, and acute cases with presentation varying between hypoxic respiratory failure and shock. This review article highlights theories behind the pathophysiology, clinical outcomes, and therapeutic options in this high mortality condition.

show abstract

“…The most common explanation is related to the interventricular interdependence. There is a preload-afterload mismatch after rapid drainage of pericardial fluid which leads to sudden increase in venous return and sudden expansion of right chambers that occurs at the expense of the left chambers leading to a possible acute left-side heart failure and pulmonary edema [3][4][5][6][7].…”

Section: Discussionmentioning

confidence: 99%

“…Up to the present, there is still no recommended minimal amount of fluid for drainage in order to prevent this syndrome. In case reports it may occur even following the drainage of < 500 mL of pericardial fluid [5][6][7]. A suggested approach is to monitor the patient's hemodynamics via right heart catheterization or echocardiography while removing the pericardial fluid.…”

Section: Discussionmentioning

confidence: 99%

“…Pericardial decompression syndrome (PDS) is a rare but po-tentially fatal complication occurring after pericardial fluid drainage [1]. There is limited epidemiologic data suggesting an overall incidence of less than 5% [2][3][4][5][6]. We aim to present a successful case of PDS in a patient with suspected malignancy occurring after surgical drainage of pericardial fluid.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Rare Case of Pericardial Decompression Syndrome in a Filipino Female Patient With Suspected Malignant Pericardial Effusion

2020

View full text Add to dashboard Cite

Pericardial decompression syndrome (PDS) is a rare, under-reported and potentially fatal complication of pericardial drainage characterized by paradoxical hemodynamic deterioration. The onset ranges from immediate to as long as 48 h post drainage. We present a case of a 51-year-old woman admitted due to progressive dyspnea. She was hemodynamically stable but with signs of cardiac tamponade. On two-dimensional echocardiography (2D-echo) there was a massive pericardial effusion in tamponade physiology. Immediate surgical drainage was done but intra-operatively there was depressed cardiac contractility necessitating inotropic support. Post-operative 2D-echo showed right ventricular (RV) and left ventricular (LV) systolic dysfunction. She was admitted in the intensive care unit (ICU) for 72 h. Repeat 2D-echo showed marked improvement in RV and LV systolic function. She was then discharged improved on the fifth hospital day. The pathophysiology of PDS is still not very clear. The simplest mechanism is that sudden removal of compressing pericardial fluid causes increased venous return with expansion of the RV at the expense of the LV leading to acute heart failure. There are no published studies to propose preventive measures and treatment remains supportive. There has been only one published case reported here in our country. We report this case of a patient who successfully recovered from PDS.

show abstract

Pericardial decompression syndrome: A rare and potentially dramatic complication of pericardiocentesis

Cited by 5 publications

References 4 publications

Pericardial Decompression Syndrome: an Uncommon But Dangerous Complication After Successful Pericardiocentesis

Pericardial Decompression Syndrome: an Uncommon But Dangerous Complication After Successful Pericardiocentesis

Pericardial Decompression Syndrome: A Comprehensive Review of a Controversial Entity

A Rare Case of Pericardial Decompression Syndrome in a Filipino Female Patient With Suspected Malignant Pericardial Effusion

Contact Info

Product

Resources

About